PL-19-493Permit No.: PL-03-19-493
Miami Shores Village Permit Type: plumbing- Residential
10050 NE 2 Ave ( (�
Miami g t`*.�.1 � IL, Work Classification: Adtiltlon/Akelon
RYE
204 Permit Status: Approved
pc V9 &!--t, sue Date:04j02/2019 Expiration: 09/30/2019
Location Address P'arcbPN ber
1321 NE 103RD ST, Miami Shores, FL 33138 1132050300120
Contacts
ADRIA I SILVERMAN Owner LONCUS PLUMBING CONTRACTORS INC Contractor
1321 NE 103 ST, MAMI SHORES, FL 33138 REMBERTO BELLO
Other: 3055420908 1300 SW 70 AVE, MIAMI, FL 33144
Business: 3052181004
Inspection Requests:
Description: PLUMBING FIXTURES FOR SHOWER FIXTURES FOR Valuation: $ 4,100.00 Inspe ti 4349
VANITIES RELOCATION OF VALVES
Total 5q Feet: 0.00
9/5/2018
PENDING REVISION APP TO REPLACE PL-03-18-611
Fees Amount
50% Renewal Fee $71.75
Total: $71.75
Building Department Copy
Payments
Date Paid Amt Paid
Total Fees
$71.75
Credit Card
03/06/2019 $50.00
Credit Card
04/02/2019 $21.75
Amount Due:
$0.00
In consideration of the issuance to me of this permit, I agree to perform the work covered hereunder in compliance with all ordinances and regulations
pertaining thereto and in strict conformity with the plans, drawings, statements or specifications submitted to the proper authorities of Miami Shores
Village. In accepting this permit I assume responsibility for all work done by either myself, my agent, servants, or employes. I understand that separate
permits are required for ELECTRICAL, PLUMBING, MECHANICAL, WINDOWS, DOORS, ROOFING and SWIMMING POOL work.
OWNERS AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all applicable laws
regulating construction and zoning. Futhermore, I authorize the above named contractor to do the work stated.
� a"�- /-/ l a- - l 9
Authorized Signature: Owner / Applicant / Contractor / Agent
April 02, 2019 Page 2 of 2
Miami Shores Village RECEIVED
Building Department MAR 0 6 2019
10050 N.E.2nd Avenue, Miami Shores, Florida 33138
Tel: (305) 795-2204 Fax: (305) 756-8972
INSPECTION LINE PHONE NUMBER: (305) 762-4949
BUILDING
PERMIT APPLICATION
❑BUILDING ❑ ELECTRIC ❑ ROOFING
FBC 201-1
Master Permit No.q
^ -`Cj I
Sub Permit No. S _ 1 q _ Q q__'3
REVISION ❑ EXTENSION [:]RENEWAL
❑PLUMBING ❑ MECHANICAL [-]PUBLIC WORKS ❑ CHANGE OF ❑ CANCELLATION ❑ SHOP
,� r CONTRACTOR DRAWINGS
JOB ADDRESS: fq"3 e-j S-roc eJ
City: Miami Shores County: Miami Dade Zip:
Folio/Parcel#: 110 Is the Building Historically Designated: Yes NO r/
Occupancy Type: Load: Construction Type: Flood Zone: BFE: FFE:
OWNER: Name (Fee Simple Titleholder): SC,& F 4CI4_1 a i lJ�.rrr�OD11 Phone#: 302 5--1 Z -030 U
Address:rbit (i (o-_- CCx Sfi(e'4,r
City: 1h _ 0-(. ( 0 fC S State: _ Zip: 3 3 13 9
Tenant/Lessee Name: N u Phone#: f
Email: GJV-i6( S 1 �r/e�mGt�► �G . Oi (iL��c • L@-rn
CONTRACTOR: Company Name: uA s (rA 4fa C�r5 Phone#: 305 - R-lq _100 y
Address:1/I531 0 0 S-("') b AN
City: State: P-- Zip: 33 144 1,
Qualifier Name: 11' er+71) &X�! Phone#: 3/j_ 1 � / DO'L
State Certification or Registration #: -;)_8 o to (0 Certificate of Clompetency #:
DESIGNER: Arch itect/E�v n/g� inee r: C c-c_L � Q L(—LC-Phone#: RSY - Z-CI e 0
Address: '920 1 W & �y � f*�C City: O State: Zip: 3 3 31
Value of Work for this Permit: $ Square/Linear Footage of Work:
Type of Work: ❑ Addition ❑ Alteration ❑ New ❑ Repair/Replace
specify color of color thru tile:
Submittal Fee $ Permit Fee $
Scanning Fee $
Technology Fee
Structural Reviews $
Radon Fee $
Training/Education Fee $
❑ Demolition
CCF $ CO/CC $
DBPR $
Notary $
Double Fee $
Bond $
TOTAL FEE NOW DUE $ Z ��
(Revised02/24/2014)
}Bonding Company's Name (if applicable)
Bonding Company's Address
City
State
Mortgage Lender's Name (if applicable)
Mortgage Lender's Address
City
State
Zip
Application is hereby made to obtain a permit to do the work and installations as indicated. I certify that no work or installation has
commenced prior to the issuance of a permit and that all work will be performed to meet the standards of all laws regulating
construction in this jurisdiction. I understand that a separate permit must be secured for ELECTRIC, PLUMBING, SIGNS, POOLS,
FURNACES, BOILERS, HEATERS, TANKS, AIR CONDITIONERS, ETC.....
OWNER'S AFFIDAVIT: I certify that all the foregoing information is accurate and that all work will be done in compliance with all
applicable laws regulating construction and zoning.
"WARNING TO OWNER: YOUR FAILURE TO RECORD A NOTICE OF COMMENCEMENT MAY
RESULT IN YOUR PAYING TWICE FOR IMPROVEMENTS TO YOUR PROPERTY. IF YOU INTEND
TO OBTAIN FINANCING, CONSULT WITH YOUR LENDER OR AN ATTORNEY BEFORE RECORDING
YOUR NOTICE OF COMMENCEMENT."
Notice to Applicant. As a condition to the issuance of a building permit with an estimated value exceeding $2500, the applicant must
promise in good faith that a copy of the notice of commencement and construction lien law brochure will be delivered to the person
whose property is subject to attachment. Also, a certified copy of the recorded notice of commencement must be posted at the job site
for the first inspection which occurs seven (7) days after the building permit is issued. In the absence of such posted notice, the
inspection will not be approved and a reinspection fee will be charged. A
Signature c ""ham )&—� S
OWNER or AGENT
The foregoing instrument was acknowledged before me this
this
day of pQr
�1 l� 20 I 1 by
'a SIB , wh�s nersonally known to
me or who has produced f-A I'( as
identification and who did take an oath.
NOTARY
J
The foregoink instru
TRACTOR
acknowledged before me this
� day of/� 7�?O % -t 20 �q by
who is personally known to
me or who has produced
identification and who did take an oath.
NOTARY PUBLIC:
Sign:_
Print:
Seal: DAYMIOLVERA
o �e
_ . Notary Public - State of Florida
Commission t GG093344
off:' My Comm. Expires Apr 11, 2021
****************************************/*/***/*/*****************
APPROVED BY / 4lr'9 Plans Examiner
Structural Review
as
Zoning
Clerk
(Revised02/24/2014)